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解读炎症:中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值在预测 COVID-19 患者重症结局中的作用

Decoding Inflammation: The Role of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Predicting Critical Outcomes in COVID-19 Patients.

作者信息

Adamescu Aida-Isabela, Tilișcan Cătălin, Stratan Laurențiu Mihăiță, Mihai Nicoleta, Ganea Oana-Alexandra, Ciobanu Sebastian, Marinescu Adrian Gabriel, Aramă Victoria, Aramă Ștefan Sorin

机构信息

Department II, Pathophysiology and Immunology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Prof. Dr. Matei Bals National Institute of Infectious Diseases, 021105 Bucharest, Romania.

出版信息

Medicina (Kaunas). 2025 Mar 30;61(4):634. doi: 10.3390/medicina61040634.

Abstract

The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are novel biomarkers that provide insight into systemic inflammation and how the immune system responds to stress or infection. These ratios have been associated with predicting clinical outcomes in various diseases, including COVID-19. This study aims to evaluate the prognostic value of NLR and PLR in anticipating ICU admission, acute respiratory failure, and disease severity in COVID-19 patients. We conducted a retrospective, observational study that included 536 patients diagnosed with COVID-19. We analyzed the NLR and PLR values at admission and correlated them with ICU admission, the onset of acute respiratory failure, and clinical outcomes. Statistical correlations were identified between elevated NLR and PLR values and the development of complications during hospitalization ( = 0.04 and = 0.00), acute hypoxemic respiratory failure ( = 0.00), and admission to the intensive care unit (ICU) ( = 0.04). No correlations were found between the values of these ratios and mortality ( = 0.46 and = 0.32) nor with the development of hepatic cytolysis ( = 0.79 and = 0.87). NLR and PLR are reliable, easily obtainable biomarkers that can aid in the early prediction of ICU admission and disease severity in COVID-19 patients, offering valuable insights for risk stratification and clinical management. Further prospective studies are needed to validate these biomarkers as part of a broader predictive model for critical care in COVID-19.

摘要

中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)是新型生物标志物,可深入了解全身炎症以及免疫系统对压力或感染的反应方式。这些比值已与预测包括COVID-19在内的各种疾病的临床结局相关联。本研究旨在评估NLR和PLR在预测COVID-19患者入住重症监护病房(ICU)、急性呼吸衰竭和疾病严重程度方面的预后价值。我们进行了一项回顾性观察研究,纳入了536例确诊为COVID-19的患者。我们分析了入院时的NLR和PLR值,并将它们与入住ICU、急性呼吸衰竭的发生以及临床结局相关联。在升高的NLR和PLR值与住院期间并发症的发生(P = 0.04和P = 0.00)、急性低氧性呼吸衰竭(P = 0.00)以及入住重症监护病房(ICU)(P = 0.04)之间发现了统计学相关性。未发现这些比值的值与死亡率(P = 0.46和P = 0.32)以及肝细胞溶解的发生(P = 0.79和P = 0.87)之间存在相关性。NLR和PLR是可靠的、易于获得的生物标志物,可有助于早期预测COVID-19患者入住ICU和疾病严重程度,为风险分层和临床管理提供有价值的见解。需要进一步的前瞻性研究来验证这些生物标志物,将其作为COVID-19重症监护更广泛预测模型的一部分。

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